It is the leading cause of years lived with disability during the most productive years of life with financial costs estimated up to €111 billion in Europe alone.
In a landmark Series on migraine in the Lancet, Prof. Messoud Ashina and colleagues address challenges in migraine care and research. They present data on migraine epidemiology and the structural obstacles that continue to obstruct provision of adequate care worldwide, and outline a model for integrated and coordinated systems of care that can be tailored to local resource availability including in low and middle-income countries. Furthermore, they discuss the immense progress that has been made in understanding the genetic and neurobiological factors underlying migraine pathogenesis and how these efforts can be used to develop precision medicine for patients with migraine. Finally, they summarise the current standard of care and provide a framework for a multidisciplinary approach to clinical management with an emphasis on individualized therapeutic plans corresponding to specific patient clinical characteristics and needs.
Despite many available therapeutic options for migraine and immense progress the past years, several obstacles remain in providing adequate care. This Series in The Lancet is a major step towards addressing these gaps.
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Migraine: disease characterisation, biomarkers, and precision medicine